Objective: To explore the value of the optimal parameters of shear wave elastography (SWE) to enhance the identification of benign and malignant thyroid nodules by C-TIRADS.Methods: The two-dimensional ultrasonography images and SWE images of 515 patients with a total of 586 thyroid nodules were retrospectively analyzed. The nodules were divided into the D ≤10 mm and D >10 mm groups according to size and were graded by C-TIRADS. With the pathological results as the gold standard, the receiver operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) was calculated to compare the diagnostic performances of C-TIRADS, SWE, and the combination of the two on the benign and malignant thyroid nodules.Results: The ROC showed that the AUC of the maximum elastic modulus (0.875) was higher than that of the mean elastic modulus (0.798) and elasticity ratio (0.772), with an optimal cutoff point of 51 kPa, which was the optimal parameter to distinguish the malignant from the benign nodules (P < 0.001). In the D ≤10 mm group, the AUC of TIRADS combined with SWE (0.955) was elevated by 0.172 compared with the application of C-TIRADS alone (0.783), and the difference was statistically significant (P < 0.05). In the D >10 mm group, the AUC of TIRADS combined with SWE (0.904) was elevated by 0.076 compared with the application of C-TIRADS alone (0.828), and the difference was statistically significant (P < 0.05). Among all nodules, the application of C-TIRADS alone had a sensitivity of 88.14%, a specificity of 74.56%, and an accuracy of 85.50% in diagnosing benign and malignant thyroid nodules, while the sensitivity, specificity, and accuracy were 93.22%, 90.35%, and 92.66%, respectively, in combination with SWE.Conclusion: The diagnostic performance of SWE in combination with TIRADS was better than that of SWE or C-TIRADS alone. Here, SWE enhanced the diagnostic performance of C-TIRADS for the benign and malignant thyroid nodules, most significantly for nodules with D ≤10 mm.

Background/Objectives: Tuberculous constrictive pericarditis (TCP) is characterized by “backward failure” and systemic venous congestion, leading to secondary multi-organ dysfunction. The Model for End-Stage Liver Disease (MELD) 3.0 score assesses liver, renal, and nutritional status, yet its prognostic utility in TCP remains undefined. This study aimed to evaluate the preoperative MELD 3.0 score as a predictor of time to discharge in patients undergoing pericardiectomy for TCP. Methods: We analyzed 190 patients undergoing pericardiectomy for TCP between 2018 and 2024. The association between preoperative MELD 3.0 scores and time to discharge (ICU, postoperative, and total) was assessed using Fine–Gray competing risks regression to account for in-hospital mortality. Models were adjusted for age, albumin, and anti-tuberculosis therapy. Results: Each unit increase in MELD 3.0 was associated with higher operative mortality (OR 1.21, p = 0.013). In multivariable analysis, a high MELD 3.0 score (>median 9.6) was independently associated with a lower probability of discharge (i.e., delayed discharge) for total hospital stay (subdistribution hazard ratio [sHR] 0.606, 95% CI 0.453–0.811), postoperative stay (sHR 0.665), and ICU stay (sHR 0.658). Preoperative albumin was also a strong predictor of faster discharge. Conclusions: The preoperative MELD 3.0 score independently predicts delayed hospital discharge after pericardiectomy for TCP, even when accounting for mortality risk. It serves as a pragmatic tool for quantifying the systemic burden of congestion and stratifying perioperative risk.